Anyone familiar with CBT, cognitive behavior therapy, knows that we're supposed to be able to improve our mood (and our life) by thinking differently. Is this true? Can we really feel better and even do better by thinking better? Is there a reason insurance companies push for this style of therapy, or is it just an old habit? Is it really an "evidence-based best practice," and if so, what does that mean? These are all good questions, but there's only one way to know if CBT is right for you. It's a very simple approach to self-change (though not always easy), so why not just try it and see for yourself if it makes sense for you?
First, let's step back and get some background. CBT (originally called CT, cognitive therapy), developed by Aaron Beck in the 60's proposes that thoughts, feelings, and behavior are all connected, and that we can attempt to overcome personal difficulties by identifying and changing unhelpful or objectively inaccurate thinking. To graphically illustrate the inter-connectedness and interdependence of these three functions, I often draw a circle, with double-headed arrows showing the flow between thoughts, feelings, and behavior.
First, let's step back and get some background. CBT (originally called CT, cognitive therapy), developed by Aaron Beck in the 60's proposes that thoughts, feelings, and behavior are all connected, and that we can attempt to overcome personal difficulties by identifying and changing unhelpful or objectively inaccurate thinking. To graphically illustrate the inter-connectedness and interdependence of these three functions, I often draw a circle, with double-headed arrows showing the flow between thoughts, feelings, and behavior.
Most of us have experienced that if we change one, the other two will change automatically. CBT emphasizes changing the thoughts that can start a cascade of negative results. We don't need studies to tell us (though many have shown this) that by making simple changes to our thinking patterns, we can have control over our unwanted mood states, such as anxiety and depression.
I don't want to exclude another, similar (almost identical) therapy: REBT, rational emotive behavior therapy (originally called RET, rational emotive therapy), developed by Albert Ellis at about the same time as CBT (Ellis and Beck were energetic rivals). According to the Albert Ellis Institute's website, REBT "is an action-oriented psychotherapy that teaches individuals to identify, challenge, and replace their self-defeating thoughts and beliefs with healthier thoughts that promote emotional well-being and goal achievement." Sounds a lot like CBT, right? Well, it is. REBT uses an alphabetical system to track the cascade of internal cognitive/emotional events that lead to sadness, agitation, worry, fear, anger, and all the rest.
Here are the ABC's of REBT:
A: Activating event
B: irrational Belief
C: Consequences of having the belief about A
D: Disputing the irrational belief
E: Effective new thinking
Here's an example I found on StressGroup.com:
A. (Activating event): Drunk people outside, making some noise.
B. (irrational Belief [iB] I have about A): They MUST NOT make any noise.
C. (Consequences of having those beliefs about A): When noisy drunk people pass in the street outside late at night and wake me up, I Feel angry. It feels bad. I lie awake feeling angry and upset and don't get back to sleep for a long time.
D. (Dispute the irrational Beliefs [iB’s] in B by turning them into questions and answers): WHY shouldn't they make any noise? Where is that commandment written in stone? Where is the evidence? Again, who made you Supreme Ruler of the Universe dictating how people Should or Must act?
E. (Effective new thinking. Substitute something rational instead of B): Drunk people are often noisy, but it's no BIG deal. I don’t like it, but I can deal with what I don’t like. Maybe I will touch base with them in the morning (when they are sober).
Here's a recording of Ellis discussing his theory: RET Example
And here's a real-world example inside that thoughts-feelings-behaviors circle that might "feel" familiar:
I don't want to exclude another, similar (almost identical) therapy: REBT, rational emotive behavior therapy (originally called RET, rational emotive therapy), developed by Albert Ellis at about the same time as CBT (Ellis and Beck were energetic rivals). According to the Albert Ellis Institute's website, REBT "is an action-oriented psychotherapy that teaches individuals to identify, challenge, and replace their self-defeating thoughts and beliefs with healthier thoughts that promote emotional well-being and goal achievement." Sounds a lot like CBT, right? Well, it is. REBT uses an alphabetical system to track the cascade of internal cognitive/emotional events that lead to sadness, agitation, worry, fear, anger, and all the rest.
Here are the ABC's of REBT:
A: Activating event
B: irrational Belief
C: Consequences of having the belief about A
D: Disputing the irrational belief
E: Effective new thinking
Here's an example I found on StressGroup.com:
A. (Activating event): Drunk people outside, making some noise.
B. (irrational Belief [iB] I have about A): They MUST NOT make any noise.
C. (Consequences of having those beliefs about A): When noisy drunk people pass in the street outside late at night and wake me up, I Feel angry. It feels bad. I lie awake feeling angry and upset and don't get back to sleep for a long time.
D. (Dispute the irrational Beliefs [iB’s] in B by turning them into questions and answers): WHY shouldn't they make any noise? Where is that commandment written in stone? Where is the evidence? Again, who made you Supreme Ruler of the Universe dictating how people Should or Must act?
E. (Effective new thinking. Substitute something rational instead of B): Drunk people are often noisy, but it's no BIG deal. I don’t like it, but I can deal with what I don’t like. Maybe I will touch base with them in the morning (when they are sober).
Here's a recording of Ellis discussing his theory: RET Example
And here's a real-world example inside that thoughts-feelings-behaviors circle that might "feel" familiar:
On Wednesday, we looked at a list of ten common cognitive distortions. Which ones showed up in your life this past week? In our group, we shared our individual usual suspects. But regardless of which thinking traps we fall in to, the process toward better outcomes is the same. We dispute the faulty thoughts and replace them with a more objective truths. Will the truth set you free? Free from symptoms and counterproductive cycles? There's one way to find out. Our disruptive thinking-feeling-behaving patterns didn't happen all at once. They were installed bit by bit, over a period of years. Undoing that damage will take time. The good news is that you get to decide how much time to spend on your healing. Try these simple techniques to change the way you approach life's stressors and let me know how it goes. What have you got to lose?
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